looning
of the rectum and ignorant operation makes further complaint to the
surgeon of the aches and pains, he is consoled by being informed that
the end of the spine will have to be removed. Irreparable damage done
and no aid at all received! It is a pity such ignorance on the subject
should exist in the medical profession in this city.

The abnormal cavity, so difficult to empty properly owing to its depth
and diseased outlet, is seldom free from gases, feces and liquids.
Daily evacuations will not empty this cavity, nor will cathartics or
diarrhea. A permanent cesspool of poisons is this, where all forms of
poisonous germs are propagated, and infect the system by absorption. No
use to take medicines for your _poor blood, bad complexion and horrid
feelings_, as they will not cleanse the augean stable so long
neglected. No use to journey to other localities for health so long as
you carry so formidable a foe to health with you.

The mucous membrane in the chronic state of the disease presents a
rather dry, indolent and bluish appearance, except that here and there
the tissues show more activity of the disease, more especially so over
the anal region, due to harsher disturbance during the act of stooling.
In the subacute or acute stage of the inflammatory process there is
more general redness and puffiness of the mucous membrane, or a swollen
condition with increased discharge of mucus and perhaps some blood.

There is a heavy, uncomfortable feeling, with more or less soreness and
pain, especially after evacuation of the feces. If a fissure or anal
ulcer is present the pain is in proportion to its size and the general
aggravation of all the diseased parts. Itching or pruritus about the
anus may accompany the trouble to a very annoying extent, being an
evidence that the anal pockets are becoming much diseased. The
partially constricted and irritable sphincter muscles become excited
during the act of stooling and react on the anal grip or contraction,
making it more intense. This latter condition may shut off the flow of
blood in a local vein; and the blood becoming coagulated forms a
painful bluish grape-like tumor at the external opening of the anus.

Abscesses may form at some portion of the diseased gut and result in an
external fistula.

Piles may co-exist in some cases of ballooning, but are usually not
annoying.

It is the local anal or external annoyances that compel the sufferer to
seek medical advice and